Effects on (neuro)developmental and behavioral outcome at 2 years of age of induced labor compared with expectant management in intrauterine growth-restricted infants: long-term outcomes of the DIGITAT trial

• Published in: American journal of obstetrics and gynecology 2012-05, Vol.206 (5), p.406.e1-406.e7
• Main Authors: van Wyk, Linda, MD, Boers, Kim E., MD, van der Post, Joris A.M., MD, PhD, van Pampus, Maria G., MD, PhD, van Wassenaer, Aleid G., MD, PhD, van Baar, Anneloes L., PhD, Spaanderdam, Marc E.A., MD, PhD, Becker, Jeroen H., MD, Kwee, Anneke, MD, PhD, Duvekot, Johannes J., MD, PhD, Bremer, Henk A., MD, PhD, Delemarre, Friso M.C., MD, PhD, Bloemenkamp, Kitty W.M., MD, PhD, de Groot, Christianne J.M., MD, PhD, Willekes, Christine, MD, PhD, Roumen, Frans J.M.E., MD, PhD, van Lith, Jan M.M., MD, PhD, Mol, Ben W.J., MD, PhD, le Cessie, Saskia, PhD, Scherjon, Sicco A., MD, PhD
• Format: Article
• Language: English
• Subjects: Adult; Ages and Stages Questionnaire; Biological and medical sciences; Child Behavior Checklist; Child Behavior Disorders - diagnosis; Child Behavior Disorders - etiology; Child, Preschool; Delivery. Postpartum. Lactation; Developmental Disabilities - diagnosis; Developmental Disabilities - etiology; DIGITAT trial; Female; Fetal Growth Retardation; Follow-Up Studies; Gynecology. Andrology. Obstetrics; Humans; intrauterine growth restriction; Labor, Induced; Logistic Models; long-term outcome; Medical sciences; Obstetrics and Gynecology; Pregnancy; Surveys and Questionnaires; Term Birth; Watchful Waiting
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2012.02.003

Objective We sought to study long-term (neuro)developmental and behavioral outcome of pregnancies complicated by intrauterine growth restriction at term in relation to induction of labor or an expectant management. Study Design Parents of 2-year-old children included in the Disproportionate Intrauterine Growth Intervention Trial at Term (DIGITAT) answered the Ages and Stages Questionnaire (ASQ) and Child Behavior Checklist (CBCL). Results We approached 582 (89.5%) of 650 parents. The response rate was 50%. Of these children, 27% had an abnormal score on the ASQ and 13% on the CBCL. Results of the ASQ and the CBCL for the 2 policies were comparable. Low birthweight, positive Morbidity Assessment Index score, and admission to intermediate care increased the risk of an abnormal outcome of the ASQ. This effect was not seen for the CBCL. Conclusion In women with intrauterine growth restriction at term, neither a policy of induction of labor nor expectant management affect developmental and behavioral outcome when compared to expectant management.